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NPI Code Detail

MEDICARE: SHARI GRESK

MEDICARE:   SHARI  GRESK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor347-226WI
2101YA0400XAddiction (Substance Use Disorder) Counselor15656-130WI
3101YA0400XAddiction (Substance Use Disorder) Counselor15680-321WI

General Provider Information

NPI Number : 1295032134
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARI GRESK
Provider Business Mailing Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number :
Provider Business Practice Location Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2011
Last Update Date : 09/17/2014

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Directions to “ SHARI GRESK ” Practice Location

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